Golytely lavage--is metoclopramide necessary?

During Golytely cleansing for colonoscopy, two dose forms of oral metoclopramide were evaluated in separate studies for patient tolerance and adequacy of preparation. In study 1, patients were randomized to 10 mg metoclopramide (n = 21) or placebo (n = 27); in study 2, 20 mg metoclopramide (n = 21) was compared to placebo (n = 25). Ten milligrams metoclopramide was not significantly different from placebo in patient acceptance for any of the assessed symptoms. Patients taking 20 mg metoclopramide had less cramping (p = 0.02), but more nausea (p = 0.03) than placebo. Time for rectal effluent to clear was similar in all groups. The percentage of patients preferring Golytely was similar in both studies (70-79%, p = NS) and 85% of all patients were willing to repeat Golytely. Physician assessment of colon cleansing showed no difference between metoclopramide or placebo in either study, with adequate preparations in 97% and optimal cleansing in 80% of all patients. Neither 10 nor 20 mg oral metoclopramide improved adequacy of colon cleansing for colonoscopy or decreased symptoms associated with Golytely lavage.